Welcome to my blog, a space designed for my patients and those interested in learning about new developments in the area of Functional and Integrative Medicine. Integrative Medicine seeks to unify the traditional allopathic model of medicine with complementary modalities of treating disease and enhancing wellness. Functional Medicine seeks to enhance the functioning of the body systems by removing toxins from the body that inhibit it's function, and by supporting the natural enzyme systems of the body to enhance their function, thus enhancing wellness and fighting disease. We seek to minimize the use of drugs in favor of other modalities that go to the "root" of the problem rather than just treat symptoms.

05/21/2014

The Weight and Fat Loss Secret...

After treating thousands of patients, trying a variety of diets myself, and experimenting on my own, I have come to the conclusion that, while there are many ways to lose "weight", there is only one way to lose fat and preserve muscle mass. Diets that restrict calories but don't change the type of food you eat don't work. Period. You will lose "weight" but that weight will come from muscle tissue and dehydration-not fat. You end up getting sick and feeling terrible; then, of course, you return to your prior eating habits and gain even more weight (fat). Thus the concept of yo-yo dieting. This is the wrong approach, taken by such programs as Jenny Craig, Weight Watchers, and Nutrisystem. You can't just "eat less" of the same stuff that got you fat in the first place and expect to lose fat and preserve muscle.

There is a way to lose fat and keep the muscle and I use it with my patients every day...

Yes, it's that simple. Notice that I did not say anything about exercise or completely eliminating fats from your diet. Of course reducing the amount of fat you consume will accelerate fat loss, but it won't prevent it if you still consume fat. However, eating high-glycemic carbohydrates, even in tiny quantities will stop your fat loss dead in it's tracks.

This method uses the innate ability of human beings, developed over eons of evolution, to survive famines. Unlike today when food and high-calorie consumables are everywhere, the usual state of affairs for human beings has historically been starvation or near-starvation. In order to survive, we had to develop methods of preserving our fat stores for that proverbial "rainy day" when food might not be available at all for weeks or even months. Thus, our fat cells will only begin to release fats for energy production after several days of "famine", not immediately.

I tell my patients that their bodies operate like a Toyota Prius. Like the Prius, we have a preferred energy source (carbohydrates and stored carbohydrates known as glycogen) and a secondary but more energy-dense energy source (fat). As long as we keep the battery charged on the Prius (analogous to our carbohydrate intake), it will not access the gas in the gas tank (our fat). However, if we exhaust the battery, the Prius will start to burn the gas in the tank for energy. Like the Prius, we need to go completely without any high-glycemic foods for about 5-7 days before we start to access our fat stores in a meaningful way.

Why is this? Because we have enzymes in our fat cells called hormone-sensitive lipases that break up the fat for energy production. The hormone they are sensitive to is insulin. If any insulin is detected, they stop breaking down fat. Insulin is released into the bloodstream by the pancreas when we consume carbohydrates such as sugars (fructose, glucose, sucrose, lactose) or starch (grain, potatoes, root vegetables, legumes). It takes about 3 days before the fat breakdown begins again after even one "cheat" with carbohydrates.

I monitor this process in my patients using a sophisticated body composition measurement device. The first week on this type of diet I note a drop in weight of about 5 pounds; however according to the body comp, it is mostly water released by the breakdown of stored carbohydrate, glycogen, and the drop in insulin. Insulin acts on the kidneys to cause fluid retention; when it decreases, you lose water weight by urinatin git out. After this phase, I see the percentage and absolute pounds of fat begin to drop rapidly. I can measure this with a urine test that detects ketones. Thus, to burn fat, one must be in "ketosis", the state where the body has accessed stored fat for energy. Ketosis is a good and necessary state to lose fat!

The amount of fat burned per week depends on the patient's muscle mass. Men can burn up to 1 pound of fat per day, about 4000 calories. Women usually burn a bit less, in the range of 3-5 pounds per week.

Some people have asked me if this is healthy, as if there is some speed limit on fat loss they shouldn't exceed. I respond that yes, this is quite healthy provided one drinks plenty of water and takes several mineral supplements. Moreover, this is natural as well. You were designed to burn fat this way. In our ancient past, after putting on some fat during the summer when food was plentiful, we would have had to hike for miles, perhaps as much as 500 miles with little or no food to reach a warmer winter hunting ground or to follow herds of grazing animals. We are designed to survive only on our stored fat if necessary. I once heard a physician expert in fat loss explain that the average obese American could conceivably walk from New York City to Miami without eating anything, arriving healthier and much lighter than when they set out on their journey. That's how much energy they have stored in their fat cells.

How does one feel when doing this sort of diet? Initially, before the fat is accessed, you feel a bit tired. After about 5 days you might feel a bit headachey. This is from the ketones that are circulating in your blood, but the body is not yet ready to burn them up for energy. Then, all of a sudden, you feel like you are plugged into a powerful battery; you have so much energy that you may not need coffee or even as much sleep. Moreover, your mind becomes sharper since ketones are an excellent food for the brain. And you have no sense of hunger as ketones suppress the appetite. And the pounds begin to just "fall off". You can literally wake up a pound lighter than when you went to bed.

I have personally taken off 21 pounds in 4 weeks effortlessly-no sweating in the gym doing cardio-just doing moderate weight lifting and eating according to this method. I use the Ideal Protein weight loss system in my practice since the food is prepackaged and this makes life so much easier for me as a busy physician. However, one could do this with food alone. One of my patients weighed in at 350 pounds; she is a 60 year old woman. She has dropped 22 pounds in 3 weeks and has noticed that her blood pressure is down to normal-without medications. She feels fantastic. It is such a joy to see her come in for her weekly weigh-in. And this is a typical response. At our last weigh-in day, the average amount of fat loss for the week was about 5 pounds.

Exercise is not important to lose fat. It is only good for stimulating muscle growth and the mental well-being that comes from exercise. If you are burning 3500 calories per day just because you are in ketosis, how much difference will 30 minutes on the stair-climber, burning only about 300 calories make?

To do this diet, one must take in enough protein, about 1 gram per pound of lean body mass per day, consume sufficient quantities of Magnesium, Calcium, Potassium, and Sodium, a multivitamin, and omega-3 containing fish oil. I recommend 2 cups of select low-glycemic veggies twice daily and consuming about 60 ounces of water per day. I will often add nutritional supplements such as acetyl-carnitine and B12 as well.

That's it. That is the secret to weight loss. Try it on your own or call my office to sign up for the Ideal Protein program.